Journal of Oral and Maxillofacial Surgery最新文献

{"title":"Navigation-Guided Management of Comminuted Zygomaticomaxillary Complex Fracture Concurrent With Orbital Reconstruction","authors":"Shuo Zhang MD ,&nbsp;Fan Yang MD ,&nbsp;Zhengkang Li MD ,&nbsp;Yuan Deng MD, PhD","doi":"10.1016/j.joms.2025.03.008","DOIUrl":"10.1016/j.joms.2025.03.008","url":null,"abstract":"<div><h3>Background</h3><div>Comminuted zygomaticomaxillary complex (ZMC-C) fracture with orbital reconstruction poses challenges for surgeons. Navigation-guided technique may be valuable for surgical reduction.</div></div><div><h3>Purpose</h3><div>This study aimed to measure the difference error between planned and actual reduction of ZMC-C fracture with orbital reconstruction using navigation-guided technique.</div></div><div><h3>Study Design, Setting, Sample</h3><div>This retrospective single-arm cohort study involved subjects with ZMC-C and orbital fractures from Jan 2017 to Jun 2019 at the Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China. Subjects with brain damage, unstable vital signs, allergy to titanium alloy implants, trauma to other facial bones or postoperative facial trauma were excluded.</div></div><div><h3>Main Outcome Variables</h3><div>The primary outcome variable was the mean 3-dimensional (3D) (Euclidean) distance error between surgical plan and actual outcome. Secondary outcomes included mean absolute distance error in transverse, vertical and anterior–posterior planes, visual analog scale score of subjects' self-satisfaction with facial aesthetics and function, orbital volume, exophthalmometry, position of bilateral zygomatic bones and surgical complications.</div></div><div><h3>Covariates</h3><div>Covariates included age and sex.</div></div><div><h3>Analyses</h3><div>Outcomes were tested using t-tests with significance at <em>P</em> &lt; .05 to determine differences between preoperative and postoperative measurements and symmetry.</div></div><div><h3>Results</h3><div>The sample included 20 subjects with a median age of 39 years (interquartile range = 24.5) and 19 (95%) were male. The mean 3D distance errors were 0.5 ± 0.3 mm at the midpoint of the fracture line at the zygomatic frontal suture, 0.7 ± 0.3 mm at the most prominent point on the surface of zygoma and 0.6 ± 0.4 mm at the intersection point of the zygomatic alveolar buttress and fracture line. The maximum mean absolute distance error was 0.8 ± 0.2 mm. Postoperative visual analog scale score improved in all subjects. Mean orbital volume was reduced by 2.2 ± 0.6 cm³, and enophthalmos improved to 0.4 ± 0.3 mm (all <em>P</em> &lt; .01). There were no significant differences in exophthalmometry, orbital volume and position of bilateral zygomatic bones between the affected and unaffected sides (<em>P</em> &gt; .05).</div></div><div><h3>Conclusion and Relevance</h3><div>Deficient movement in the anterior–posterior plane mainly contributes to 3D distance error. The mean distance error was clinically acceptable with the aid of navigation-guided technique in managing ZMC-C fracture with orbital reconstruction.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages 691-699"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral and Maxillofacial Surgery Training Programs Should Adopt a Standardized Model of Graded Surgical Autonomy","authors":"Akshay Govind DMD, MD, MPH ,&nbsp;Joseph Zwischenberger MD ,&nbsp;Phillip Harrison DDS, MD","doi":"10.1016/j.joms.2025.02.008","DOIUrl":"10.1016/j.joms.2025.02.008","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages 651-654"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Combining Arthrocentesis With Injectable Platelet-Rich Fibrin Outperform Arthrocentesis or Injectable Platelet-Rich Fibrin Alone in Alleviating Pain and Improving Function in Temporomandibular Joint Dysfunction?","authors":"Ram Sundar Chaulagain BDS, MDS (OMFS) ,&nbsp;Saurabh S. Simre BDS, MDS ,&nbsp;Sagrika Shukla BDS, MDS ,&nbsp;Prem Kumar Rathod BDS, MDS ,&nbsp;Adity Bansal BDS, MDS ,&nbsp;Ashi Chug BDS, MDS, PhD","doi":"10.1016/j.joms.2025.02.006","DOIUrl":"10.1016/j.joms.2025.02.006","url":null,"abstract":"<div><h3>Background</h3><div>Arthrocentesis (AC), with/without intra-articular agents like hyaluronic acid, steroids, platelet-rich plasma, and platelet-rich fibrin, is used with varying effectiveness to manage temporomandibular joint (TMJ) intra-articular pain and dysfunction (IPD).</div></div><div><h3>Purpose</h3><div>The purpose of this study was to measure changes in pain, range of motion, and quality of life (QOL) in subjects with IPD who underwent AC/injectable platelet-rich fibrin (i-PRF)/AC + i-PRF injection.</div><div><strong>Study design, setting and sample:</strong> A single-centre randomized clinical trial was conducted at All India Institute of Medical Sciences, Rishikesh, on patients with unilateral IPD (Wilkes II, III, and IV) confirmed by magnetic resonance imaging. Exclusion criteria included age below 18/above 50 years, autoimmune diseases, magnetic resonance imaging contraindications, previous TMJ surgery, congenital/developmental TMJ disorders, and TMJ lesions.</div></div><div><h3>Predictor variable</h3><div>Predictor variables were treatment modalities (AC/i-PRF/AC + i-PRF) assigned using computer generated randomization.</div></div><div><h3>Main outcome variable</h3><div>The primary outcome was TMJ pain at 3 months measured with visual analog scale. Secondary outcomes included range of motion, muscle tenderness, and QOL. Data was collected preoperatively (T0) and postoperatively at 10 days (T1), 1 month (T2), and 3 months (T3) by a blinded observer.</div></div><div><h3>Covariates</h3><div>Covariates included age, sex, and involved joint (right/left) and Wilkes staging.</div></div><div><h3>Analyses</h3><div>Repeated measure analysis of variance with post hoc analysis was used (<em>P</em> &lt; .05).</div></div><div><h3>Results</h3><div>The study included 48 patients with mean ages of 29.9 ± 7.8 years (AC), 36.5 ± 10.9 years (i-PRF), and 27.2 ± 8.5 years (AC + i-PRF) (<em>P</em> = .019), with a higher female prevalence: 68.8% in AC and i-PRF, and 87.5% in AC + i-PRF (<em>P</em> = .4). TMJ pain significantly reduced at T3 in AC + i-PRF compared to AC (mean difference[MD]: 2.1, 95% confidence interval [CI]: 3.3 to 0.9; <em>P</em> &lt; .01) and i-PRF (MD: 1.5, 95% CI: 2.7 to 0.3; <em>P</em> = .012).AC + i-PRF also showed significant improvement in mouth opening (MD: 3.9, 95% CI: 1.1 to 6.8; <em>P</em> = .005) and QOL compared to AC (MD: −4.3, 95% CI: −7.7 to −0.9; <em>P</em> = .009) and i-PRF (MD: −3.6, 95% CI: −6.9 to −0.2; <em>P</em> = .03).</div></div><div><h3>Conclusion</h3><div>AC + i-PRF outperforms AC/i-PRF alone in improving pain, range of motion and overall QOL in Wilkes II, III, and IV, making it a promising treatment option for TMJ IPD.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages 658-669"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the Infection Rates of Strut Versus Straight Plates in Sagittal Split Osteotomies","authors":"Stephen E. Higgins Jr DMD, MPH ,&nbsp;Valmont Desa DDS, MD","doi":"10.1016/j.joms.2025.03.001","DOIUrl":"10.1016/j.joms.2025.03.001","url":null,"abstract":"<div><h3>Background</h3><div>Sagittal split osteotomies can be rigidly fixated through various methods. Unfortunately, infection remains a common postoperative complication.</div></div><div><h3>Purpose</h3><div>The purpose was to estimate postoperative infection rates between strut and straight plates for internal fixation of sagittal split osteotomies.</div></div><div><h3>Study Design, Setting, Sample</h3><div>We implemented a retrospective cohort study and included a consecutive series of patients with sagittal split osteotomies performed at the University of Nebraska Medical Center. The cases were performed by a single surgeon with a chief as resident surgeon. Exclusion criteria included any patient with unilateral surgery, mandibular midline osteotomy, previous mandible reconstruction, distraction osteogenesis, previous facial trauma history, and less than 12 weeks of follow-up.</div></div><div><h3>Predictor Variable</h3><div>Primary predictor variable was plate type (strut vs straight). The choice of plate was not based on the surgical plan.</div></div><div><h3>Main Outcome Variable(s)</h3><div>The primary outcome variable was postoperative infection. This was defined as purulent discharge, incision and drainage, or prescription of antibiotics. Secondary outcomes include hardware removal and neurosensory function.</div></div><div><h3>Covariates</h3><div>Covariates included demographics, smoking, alcohol and drug use, single/double jaw, advancement/setback, length of movement, and perioperative third molar extraction.</div></div><div><h3>Analyses</h3><div>Fisher’s exact test, χ² test, and Student’s <em>t</em> test were computed to measure bivariate association. The relative risks (RRs) and their 95% CIs were reported. <em>P</em> values &lt; .05 were considered statistically significant.</div></div><div><h3>Results</h3><div>The sample comprised 112 subjects. There were 51 (45.5%) straight plate and 61 (54.5%) strut plate. There were 32 (62.7%) women in the straight plate group, mean age 25.55 ± 13.34 years and 39 women (63.9%) in the strut plate group, mean age 29.02 ± 11.97 years. Postoperative infection was the most common reason for plate removal (n = 10). Strut plates, relative to straight plates, were associated with a 23% increase (RR 1.23, 95%, CI 0.47 to 2.16, <em>P</em> &lt; .7) in infections, a 25% increase (RR 1.25, 95%, CI 0.45 to 2.27, <em>P</em> &lt; .5) in hardware removal, and a 17% increase (RR 1.17, 95% CI 0.33 to 2.44, <em>P</em> &lt; .7) in postoperative neurosensory disturbance at 3 months for sagittal split osteotomies.</div></div><div><h3>Conclusions and Relevance</h3><div>The choice of internal fixation plate, strut versus straight, was not associated with postoperative infection, hardware removal, or postoperative neurosensory function deficit.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages 681-690"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Concentrated Growth Factor on Improving Postoperative Comfort in Patients Undergoing Coronectomy for Impacted Lower Third Molars: A Double-Blinded Split-Mouth Randomized Controlled Clinical Study","authors":"Muharrem Ergun Dudak DDS ,&nbsp;Aylin Calis DDS, PhD ,&nbsp;Huseyin Koca DDS, PhD","doi":"10.1016/j.joms.2025.03.005","DOIUrl":"10.1016/j.joms.2025.03.005","url":null,"abstract":"<div><h3>Background</h3><div>Following coronectomy, pain and edema are adverse side effects. Concentrated growth factor (CGF) is recognized for its potential to enhance wound healing, reduce inflammation and may help to improve postoperative comfort following coronectomy.</div></div><div><h3>Purpose</h3><div>The study purpose was to measure and compare postoperative pain and edema between CGF and control treatments in patients undergoing bilateral coronectomies.</div></div><div><h3>Study Design, Setting, and Sample</h3><div>In this split-mouth, double-blind, randomized controlled study conducted at Ege University Faculty of Dentistry, Department of Oral and Maxillofacial Surgery in Izmir, Turkey, patients aged 18 to 65 years at risk of mandibular nerve injury underwent bilateral coronectomy. Patients over 65 years of age or those with systemic conditions contraindicating surgery were excluded. Patients and the researcher responsible for data collection and analysis were blinded to the intervention.</div></div><div><h3>Independent Variable</h3><div>The independent variable was wound management. Within subjects, the treatment sides were randomly assigned to CGF treatment or control.</div></div><div><h3>Main Outcome Variable</h3><div>The outcome variable was postoperative comfort measured using pain and edema. Pain was measured using the visual analog scale for 7 days after surgery. Edema was quantified in millimeters in 3 planes preoperatively and on postoperative days 2 and 7.</div></div><div><h3>Covariates</h3><div>Age, sex, and depth of impaction were covariates.</div></div><div><h3>Analyses</h3><div>The conformity of edema measurements to normal distribution was assessed with the Shapiro-Wilk test, analysis of variance for repeated measures and Bonferroni correction, and supported by paired two-sample <em>t</em> test (significant interaction); since pain levels did not fit the normal distribution (ordinal scale), the nonparametric Brunner and Langer model (LD-F2) and Benjamini-Hochberg procedure were used. Statistical significance was defined as (<em>P</em> &lt; .01).</div></div><div><h3>Results</h3><div>The sample included 35 subjects, comprising 12 (34.3%) males and 23 (65.7%) females, with a mean age of 32.7 ± 11.42 (standard deviation). Visual analog scale scores were significantly lower on the CGF side for the first 6 days (<em>P</em> &lt; .001) but not on day 7 (<em>P</em> = .6). Postoperative second day edema was statistically significantly lower in the 2 planes on the CGF side (<em>P</em> &lt; .001, <em>P</em> = .007, <em>P</em> = .8) but not on day 7 in any plane (<em>P</em> = .5, <em>P</em> = .8, <em>P</em> = .1).</div></div><div><h3>Conclusions and Relevance</h3><div>Our study shows that CGF enhances postoperative comfort by minimizing pain and edema. Additional interventions may be necessary for patients undergoing coronectomy due to the potential for significant postoperative discomfort.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages 738-747"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chondroid Diffuse Tenosynovial Giant Cell Tumor of the Temporomandibular Joint: A Case of a Rare Maxillofacial Tumor With Unique Pathophysiology and Therapeutic Considerations.","authors":"Katherine Richardson, Hwi Sean Moon, Faizan Alawi, Helen Giannakopoulos","doi":"10.1016/j.joms.2025.05.019","DOIUrl":"https://doi.org/10.1016/j.joms.2025.05.019","url":null,"abstract":"<p><p>Diffuse tenosynovial giant cell tumors (D-TGCT) represent a rare group of benign proliferative lesions originating from the synovium of joints, bursae, and tendon sheaths, with infrequent involvement of the temporomandibular joint (TMJ). Among these, chondroid D-TGCT, previously known as pigmented villonodular synovitis with chondroid metaplasia, constitutes an even rarer subtype displaying a specific affinity for the TMJ. Despite its distinctive nature, only a limited number of cases (n = 30) of chondroid D-TGCT have been extensively documented in existing literature. This case report highlights an unusual instance of chondroid variant of D-TGCT within the TMJ and introduces novel adjuvant therapeutic techniques to prevent recurrence. Given the absence of definitive treatment protocols, our objective is to review existing literature on predictive markers for D-TGCT, aiming to facilitate timely diagnosis via core biopsy technique, and explore potential adjunctive therapeutic modalities that could complement surgical resection, especially in managing these locally aggressive tumor variants.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic Melatonin Improves Regeneration After Facial Nerve Crush Injury in a Rat Model.","authors":"Atahan Unaldi, Fatma Helvacioglu, Nurettin Diker","doi":"10.1016/j.joms.2025.05.016","DOIUrl":"10.1016/j.joms.2025.05.016","url":null,"abstract":"<p><strong>Background: </strong>Management of facial nerve injuries is challenging, and melatonin has been shown to promote structural and functional neural regeneration.</p><p><strong>Purpose: </strong>The study's purpose was to measure the regenerative potential of systemic melatonin treatment after facial nerve crush injury.</p><p><strong>Study design, setting, sample: </strong>This was a double-blind, randomized, controlled study in an animal model conducted at the Bezmialem Vakif University. Twenty-four rats were included in the present study.</p><p><strong>Predictor variable: </strong>The primary predictor variable was the different doses of systemic melatonin treatment. The animals were randomly divided into 3 treatment groups (n = 8 each): melatonin 5 mg/kg/day, melatonin 20 mg/kg/day, and carrier solution alone (control). The intraperitoneal injections were administered during the 28-day healing period.</p><p><strong>Main outcome variable(s): </strong>The primary outcome variable was the histomorphometric analysis (mean axonal and Schwann cells density per unit square micrometer). The secondary outcome variable was facial nerve activity assessed by electromyography (amplitude and duration values) and functional observation (whisking biometrics and blinking reflex).</p><p><strong>Covariates: </strong>None.</p><p><strong>Analyses: </strong>The normally distributed parameters were evaluated with one-way analysis of variance and Bonferroni post hoc analysis for intergroup comparison. The Fisher exact test and the χ² test were used to examine categorical data.</p><p><strong>Results: </strong>Histomorphometric analysis revealed that the number of axons with the optimum G-ratio in the control group (180) was statistically significantly lower than expected (217.33; P < .01). The mean axonal density was statistically significantly higher in 5 mg/kg (12.99 ± 2.20/1,000μ²; P = .01) and 20 mg/kg (13.47 ± 1.57/1,000 μ²; P = .004) melatonin treatment groups compared to control group (9.43 ± 2.57/1,000 μ²). Both treatment groups presented higher EMG amplitude (1.59 ± 0.28 for 5 mg/kg melatonin group and 1.94 ± 0.31 for 20 mg/kg melatonin group) than the control group (1.25 ± 0.15; P < .05), and both treatment groups presented shorter duration values (19.16 ± 1.35 for 5 mg/kg melatonin group and 20.39 ± 1.62 for 20 mg/kg melatonin group) than the control group (24.24 ± 3.80; P < .05). Whisking amplitude was statistically significantly higher in 5 mg/kg (61.25 ± 14.28; P = .009) and 20 mg/kg (63 ± 14.69; P = .003) melatonin groups compared to the control group (35.62 ± 8.21) at the end of treatment period.</p><p><strong>Conclusion and relevance: </strong>Both supraphysiological doses of systemic melatonin treatment enhanced regeneration after facial nerve crush injury in an animal model. Our findings invite further research on the clinical potential of melatonin-induced facial nerve regeneration.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced Recovery After Orthognathic Surgery: Evidence Synthesis for Postoperative Care.","authors":"Michael V Joachim, Michael Miloro","doi":"10.1016/j.joms.2025.05.015","DOIUrl":"10.1016/j.joms.2025.05.015","url":null,"abstract":"<p><strong>Background: </strong>Enhanced recovery after surgery (ERAS) protocols have demonstrated substantial benefits across surgical specialties, including reduced hospital stays, decreased complications, and improved patient satisfaction. Despite growing interest in ERAS for orthognathic surgery, the optimal combination of postoperative elements remains undefined.</p><p><strong>Purpose: </strong>This evidence synthesis identifies, evaluates, and synthesizes postoperative outcomes following orthognathic surgery that are improved by ERAS protocols.</p><p><strong>Study design, setting, sample: </strong>A systematic search of PubMed/MEDLINE, Cochrane Library, Embase, and Web of Science was conducted from inception through April 2025. Studies were included if they evaluated postoperative elements of ERAS protocols in orthognathic surgery with reported outcomes on length of stay, pain, opioid consumption, postoperative nausea and vomiting (PONV), or complications. Articles were screened by 2 independent reviewers following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.</p><p><strong>Results: </strong>Six studies (986 patients) met inclusion criteria. Evidence quality, assessed using Grading of Recommendations Assessment, Development, and Evaluation, was moderate for multimodal pain management and PONV prophylaxis but low to very low for mobilization, nutrition, and discharge planning. The strongest evidence supported scheduled nonopioid analgesics with limited opioids for breakthrough pain, which reduced maximum pain scores (5.50 ± 2.20 vs 7.50 ± 1.73, P < .001) and opioid consumption (9.38 ± 11.42 mg vs 51.44 ± 30.67 mg, P < .001). Risk-stratified multimodal PONV prophylaxis reduced PONV incidence (38.3 vs 63.2%, P = .005). Standardized discharge criteria facilitated same-day discharge (86.8 vs 20%, P < .01). Evidence for mobilization, nutrition management, and functional rehabilitation was limited and inconsistent.</p><p><strong>Conclusions and relevance: </strong>Implementation of ERAS protocols for orthognathic surgery was associated with improved pain control, lower opioid consumption, decreased PONV, and shorter length of stay. Scheduled nonopioid analgesics, limited use of opioids for breakthrough pain, and risk-stratified PONV prophylaxis showed the most consistent benefits. Future research should address knowledge gaps regarding early mobilization, nutrition management, and standardized discharge planning through well-designed prospective studies.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bevacizumab-Conjugated Curcumin Nanoparticles Promote Cytotoxicity and Apoptosis in Human Malignant Oral Keratinocytes In Vitro.","authors":"Rethinam Senthil","doi":"10.1016/j.joms.2025.05.014","DOIUrl":"10.1016/j.joms.2025.05.014","url":null,"abstract":"<p><strong>Background: </strong>Targeted, biologically-based therapeutic agents seek to reduce tumor burden and treatment side effects. Curcumin nanoparticle (CuNP)-based drug delivery systems conjugated have been shown to target and inhibit the growth of human malignant oral keratinocytes in vitro.</p><p><strong>Purpose: </strong>The purpose of this study was to conjugate physiologically clotted fibrin (PCF) and CuNPs with bevacizumab (BVZ), characterize the newly formed nanoparticles, and test their growth inhibition on human oral cancer cells in vitro.</p><p><strong>Study design, setting, sample: </strong>This in-vitro study was conducted at the White Lab, Cell Culture Laboratory, Saveetha; Dental College and Hospitals, Chennai, from June 2 to August 20, 2024. The human malignant oral keratinocyte cell line UM-SCC-1 was used.</p><p><strong>Predictor variables: </strong>The primary predictor variable was BVZ in the BVZ: PCF: CuNP nanoparticle formulation. The control consisted of PCF: CuNP nanoparticles.</p><p><strong>Main outcome variables: </strong>The outcome variables were the successful synthesis of BVZ: PCF: CuNP and growth inhibition of UM-SCC-1 cells. The synthesized nanoparticles were characterized using ultraviolet, fourier-transform infrared, and high-resolution scanning electron microscopy. In vitro cytotoxicity, apoptosis, and scratch wound assays were conducted to assess the growth inhibition of UM-SCC-1 cells by BVZ: PCF: CuNPs.</p><p><strong>Covariates: </strong>No covariates were tested in this study.</p><p><strong>Analyses: </strong>The experimental data were analyzed using GraphPad Prism software (version 9.5.1). Cytotoxicity results are expressed as mean ± standard deviation, and statistical significance was determined using one-way analysis of variance (ANOVA) followed by Tukey's post hoc test. Statistical significance was set at P < .05.; State the statistical analyses used, the level of statistical significance, and the statistical software package used.</p><p><strong>Results: </strong>The ultraviolet spectrum showed a peak at 419 nm. Fourier-transform infrared confirmed conjugation with amide bands at 1643, 1535, and 1235 cm^-1. Scanning electron microscopy showed spherical CuNPs (40-100 nm) and fibrin fibers (1-2 μm). BVZ: PCF: CuNPs decreased cell viability by 37%, with IC₅₀ of 3.2 versus 5.8 μM (P < .05). Apoptosis was higher in the BVZ group (65 vs 42%, P < .05).</p><p><strong>Conclusion and relevance: </strong>BVZ: PCF: CuNP was successfully synthesized and showed greater growth inhibition of a human malignant oral keratinocyte line in vitro. Future studies should be performed to further characterize this novel nanoparticle in vitro and in vivo.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimizing Chairside Conversion and Lab Work for Full Arch Restorations-A Technique Note.","authors":"Michael S Block","doi":"10.1016/j.joms.2025.05.013","DOIUrl":"10.1016/j.joms.2025.05.013","url":null,"abstract":"<p><p>The technique described herein uses a single wand that includes both intraoral scanning and intraoral photogrammetry to accurately capture abutment positions as well as soft tissue. This method minimizes the risk of malalignment because the abutment and soft tissue images are combined within one platform. At surgery, implants and multiunit abutments are placed and the abutments are scanned with an intraoral photogrammetry wand. These files are uploaded to the lab technician merges the files with a preoperative digital plan. A prosthesis is then fabricated and placed with no chairside conversion. This method is time-efficient and cost-efficient with no need for the lab technician or restorative dentist to be at implant placement surgery.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}